TY - JOUR
T1 - Incremental value of left atrial strain to predict atrial fibrillation recurrence after cryoballoon ablation
AU - Motoc, Andreea
AU - Luchian, Maria-Luiza
AU - Scheirlynck, Esther
AU - Roosens, Bram
AU - Chameleva, Hadischat
AU - Gevers, Maxim
AU - Galloo, Xavier
AU - von Kemp, Berlinde
AU - Ramak, Robbert
AU - Sieira, Juan
AU - de Asmundis, Carlo
AU - Chierchia, Gian-Battista
AU - Magne, Julien
AU - Weytjens, Caroline
AU - Droogmans, Steven
AU - Cosyns, Bernard
PY - 2021/11
Y1 - 2021/11
N2 - OBJECTIVE: Atrial fibrillation (AF) recurrence occurs in approximately 25% of the patients undergoing cryoballoon ablation (CBA), leading to repeated ablations and complications. Left atrial (LA) dilation has been proposed as a predictor of AF recurrence. However, LA strain is a surrogate marker of LA mechanical dysfunction, which might appear before the enlargement of the LA. The purpose of this study was to evaluate the additional predictive value of LA function assessed using strain echocardiography for AF recurrence after CBA.METHODS: 172 consecutive patients (62.2 ± 12.2 years, 61% male) were prospectively analyzed. Echocardiography was performed before CBA. Blanking period was defined as the first three months post-ablation. The primary endpoint was AF recurrence after the blanking period.RESULTS: 50 (29%) patients had AF recurrence. In the overall study population, peak atrial longitudinal strain (PALS) ≤ 17% had the highest incremental predictive value for AF recurrence (HR = 9.45, 95%CI: 3.17-28.13, p < 0.001). In patients with non-dilated LA, PALS≤17% remained an independent predictor of AF recurrence (HR = 5.39, 95%CI: 1.66-17.52, p = 0.005).CONCLUSIONS: This study showed that LA function assessed by PALS provided an additional predictive value for AF recurrence after CBA, over LA enlargement. In patients with non-dilated LA, PALS also predicted AF recurrence. These findings emphasize the added value of LA strain, suggesting that it should be implemented in the systematic evaluation of AF patients before CBA.
AB - OBJECTIVE: Atrial fibrillation (AF) recurrence occurs in approximately 25% of the patients undergoing cryoballoon ablation (CBA), leading to repeated ablations and complications. Left atrial (LA) dilation has been proposed as a predictor of AF recurrence. However, LA strain is a surrogate marker of LA mechanical dysfunction, which might appear before the enlargement of the LA. The purpose of this study was to evaluate the additional predictive value of LA function assessed using strain echocardiography for AF recurrence after CBA.METHODS: 172 consecutive patients (62.2 ± 12.2 years, 61% male) were prospectively analyzed. Echocardiography was performed before CBA. Blanking period was defined as the first three months post-ablation. The primary endpoint was AF recurrence after the blanking period.RESULTS: 50 (29%) patients had AF recurrence. In the overall study population, peak atrial longitudinal strain (PALS) ≤ 17% had the highest incremental predictive value for AF recurrence (HR = 9.45, 95%CI: 3.17-28.13, p < 0.001). In patients with non-dilated LA, PALS≤17% remained an independent predictor of AF recurrence (HR = 5.39, 95%CI: 1.66-17.52, p = 0.005).CONCLUSIONS: This study showed that LA function assessed by PALS provided an additional predictive value for AF recurrence after CBA, over LA enlargement. In patients with non-dilated LA, PALS also predicted AF recurrence. These findings emphasize the added value of LA strain, suggesting that it should be implemented in the systematic evaluation of AF patients before CBA.
KW - atrial fibrillation
KW - prediction
KW - cryoballoon ablation
KW - left atrial strain
UR - http://www.scopus.com/inward/record.url?scp=85119991144&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0259999
DO - 10.1371/journal.pone.0259999
M3 - Article
C2 - 34797844
VL - 16
JO - PLoS ONE
JF - PLoS ONE
SN - 1932-6203
IS - 11
M1 - e0259999
ER -